Monocytes and Macrophages in Pregnancy and Pre-Eclampsia

Abstract

Preeclampsia is an important complication in pregnancy, characterized by hypertension and proteinuria in the second half of pregnancy. Generalized activation of the inflammatory response is thought to play a role in the pathogenesis of pre-eclampsia. Monocytes may play a central role in this inflammatory response. Monocytes are short lived cells that mature in the circulation and invade into tissues upon an inflammatory stimulus and develop into macrophages. Macrophages are abundantly present in the endometrium and play a role in implantation and placentation in normal pregnancy. In pre-eclampsia, these macrophages appear to be present in larger numbers and are also activated. In the present review, we focused on the role of monocytes and macrophages in the pathophysiology of pre-eclampsia.

Prolonged activation of innate antiviral gene signature after childbirth is determined byIFNL3genotype

“…Second, an effect of IFNL3 genotype on ISG expression has not been previously described for CD14 + cells to our knowledge. Monocytes are known to increase in both frequency and activation marker expression during pregnancy and labor (9,15), with roles in placental vascularization, initiation of labor, and potentially immune protection during a period of reduced adaptive immunity. Nonetheless, the stimulus for continued IFN signaling in CD14…”

“…Although tolerance mechanisms are necessary for fetal survival, suppressed cellular immunity renders pregnant women susceptible to severe infection with certain pathogens (3)(4)(5)(6)(7). Augmented innate immunity may partially offset the reduced adaptive immune protection in pregnancy (8,9). Following delivery, however, the maternal immune system is released from the constraints of pregnancy.…”

Impairment of the accumulation of decidual T cells, NK cells, and monocytes, and the poor vascular remodeling of spiral arteries, were observed in oocyte donation cases, regardless of the presence or absence of preeclampsia

“…Immunological tolerance is important for preventing fetal rejection in allogeneic pregnancy (Tafuri et al, 1995;Aluvihare et al, 2004;Sasaki et al, 2004;Zenclussen et al, 2005) and immunocompetent cells contribute to normal placentation or spiral artery remodeling by extravillous trophoblasts (EVT) (Smith et al, 2009;Lash et al, 2010). Uterine NK cells and macrophages play important roles in vascular smooth muscle cell separation and the replacement of vascular endothelial cells by EVT (Wallace et al, 2015;Faas et al, 2014;Smith et al, 2009;Lash et al, 2010;Naruse et al, 2009). Regulatory T (Treg) cells play a central role in the induction and maintenance of tolerance during pregnancy (Aluvihare et al, 2004;Sasaki et al, 2004;Tilburgs et al, 2008;Rowe et al, 2012;Samstein et al, 2012) and decreasing Treg cells in peripheral blood and the decidua of preeclampsia were reported (Sasaki et al, 2007;Santner-Nanan et al, 2009;Quinn et al, 2011;Toldi et al, 2012;Hsu et al, 2012).…”

Marginal zone B cells emerge as a critical component of pregnancy well-being

“…Alongside well-known and deeply investigated immune adaptations involving dendritic cells (Segerer et al 2012), T cells (Ruocco et al 2014), NK cells (Parham 2004) and macrophages (Faas et al 2014), the B cell compartment was recently demonstrated to undergo profound modifications and adaptations during pregnancy.…”